In addition to legislative efforts to strip women of reproductive rights, anti-choice activists are undertaking a coordinated campaign to permanently alter the relationship between women, medicine and the law. This campaign includes changing the manner in which doctors treat women vis-a-vis changes to informed consent laws and an intentional expansion of “conscience clause” exceptions. These changes are designed to legally insulate discriminatory conduct in the name of religious liberty while effectively returning the standard of care used in treating girls and women to one that does not legally recognize full capacity and right to consent to treatment.

To that already troubling list add efforts to “reform” medical review boards so that they reflect and promote a theological view of the human rights of women rather than an epistemological one. In places like Nebraska, Kansas and Iowa anti-choice activists have made inroads in what are essentially administrative or governing bodies, finding seats on medical review boards and boards of regents in public institutions and settings. The result is a shift away from science-based review of reproductive health care decisions and an embrace of a theological one. For women this is a shift with catastrophic consequences that cannot be easily undone.

Medical review boards, like the Kansas Board of Healing Arts or the Iowa Board of Medicine are tasked with, among other things, reviewing complaints against doctors and facilities and regulating professional licensing. Traditionally these boards have been non-partisan, or at least not overtly-political bodies that left the controversy around issues like abortion and stem-cell research to the politicians while setting science-based agendas for themselves.

But that’s all changed as anti-choice advocates see an opportunity in “stacking” boards with ideologues who will advance an anti-choice, anti-woman political agenda with very little, if any, public accountability. In Kansas Gov. Sam Brownback (R) pushed for the appointment of Operation Rescue defense attorney Richard Marcias to its medical review board while in Iowa a Catholic priest now serves on that state’s board after Gov. Terry Brandstad’s first choice–another anti-choice activist with ties to Operation Rescue–was rejected as too controversial a candidate.

The administrative review process these bodies undertake serves as important a role as the courts in providing individuals a means to enforce their rights and their decisions often carry the full weight and effect of the law. That is exactly why anti-choice advocates are trying to game the system here.

Take Kansas, where Operation Rescue is waging a campaign to intimidate and shame women and girls who have had abortions by posting leaked medical information about them online. Complaints about this behavior go to two places: the Kansas Board of Healing Arts and local law enforcement. Those bodies decide what claims to investigate and, as importantly, how many resources to dedicate to prosecution of those claims. In Kansas the result has been an open invitation to anti-choice zealots to harass and intimidate women out of obtaining care they need, all with the blessing of the state.

In the short-term these “reforms” damage women and girls’ lives by enabling criminal harassment and efforts to squash the exercise of their rights. In the long-term these reforms relegate women and girls to second-class citizens under the law. Their claims to injury are not viewed as legitimate, they are not investigated and their injuries remain un-remedied. In this sense anti-choice advocates do not need to change the law to strip rights. They just need to selectively enforce it.